Mashhad University of Medical SciencesIranian Journal of Neonatology IJN2251-75102322-21585320141201Evaluation and prognosis of neonates with asphyxia treated by hypothermia14ENAbdollahJannatdoustAssistant professor of neonatology , Pediatric health research center ,Tabriz university of medical science .Tabriz /Iran.jannatdousta@gmail.comMohammadBarzegarProfessor of pediatric neurology, Pediatric health research center ,tabriz university of medical science .mm_barzegar@yahoo.comMohammad bagherHosseinineonatologist ,tabriz university of medical sciencehosseini_mb@yahoo.comBehanamAsgharipediatrician, Tabriz university of medical science .asghari.behnam@gmail.comFarzadIlkhchooyiMD,pediatric health research center .farzad.sarfaraz@gmail.com10.22038/ijn.2014.4140Background: Asphyxia is a perinatal accident with a high mortality rate, therapeutic hypothermia in both head or whole body was suggested as effective therapeutic methods. In this study, we compare these methods in neonates with asphyxia.Methods and Materials: 16 neonates with asphyxia in two hospitals including Alzahra(head hypothermia) and Taleghani hospital (total body hypothermia) went under the therapeutic hypothermia for 72 hours. Maintaining temperature controlled by several sensors precisely. Body cooling were performed on the trunk and limbs of the neonates. Temperature and vital signs controlled every 1 hour and biochemistry, and coagulation tests were performed regularly, early and late complications of patients including developmental disorders, were evaluated. Comparing two groups was performed using Chi square and Mann Whitney U test, on the software SPSS16 , p less than 0.05 was significant.Results: 16 cases with gestation age of 38 ± 2weeks were enrolled. Of 9 cases by head cooling 1 patient died and 2 patients got mild developmental disorders. Of the 7 newborns of whole body cooling trail, 3 died and 1 got minor developmental disorders and one case showed major.. Feeding time (head group 5±2 , body group 8±5 days) and also discharge time (head group 15±8 days and body group 14±5 days ) had no significant differences .Conclusion: It seems head hypothermia method is associated with a lower mortality than the whole body method. In the above sample size, the differences were not statistically significant. Performing these procedures on larger samples could be approval.Hypoxic ischemic encephalopathy,cooling,Asphyxia,Neonateshttp://ijn.mums.ac.ir/article_4140.htmlhttp://ijn.mums.ac.ir/article_4140_218810b23eedceeeeaa4849f698a08d6.pdfMashhad University of Medical SciencesIranian Journal of Neonatology IJN2251-75102322-21585320141201Evaluation of the Prevalence of Macrosomia and the Maternal Risk Factors59ENMahnaz-MardaniAsociate professor f nutrition, Lorestan university of Medical Sciencesmsmardani@yahoo.comAmirhosseinkhalkhaliraddepartment f nutrition, lorestan university of medical sciencesamihossein.khalkhalirad@yahoo.comSajjadRosstadepartment of nutrition, lorestan university of medical sciencessajjad.roosta@yahoo.comPouriaRezapourdepartment of English literature,Chamran universityms.mardani@gmail.com10.22038/ijn.2014.4141AbstractBackground: Macrosomia is a term applied to newborns with a birth weight of 4000 gr or above. Perinatal mortality and morbidity is increased in fetal macrosomia. Clavicular fracture, injury to brachial plexus, and hypoglycemia are important side effects. Mother’s age, body mass index of mother, weight gain in pregnancy, mother’s height, diabetes, history of macrocosmic delivery, gestational age, parity, and fetal sex are factors causing macrosomia. The purpose of this cross-sectional study was to evaluate the frequency and risk factors of macrosomia in Asalian hospital of Khorramabad in the summer of 2010. Methods: The data collection instrument was a questionnaire containing 10 variables as the risk factors of macrosomia. The data were analyzed using the SPSS software.Results: 59 cases of macrosomia were found in 500 living births. The results showed that the frequency of macrosomia was 11.8%. 69.5% of the neonates were male and 30.5% were female. Maternal risk factors were mother's age at pregnancy, mother's obesity (BMI>=30), weight gain more than 18 kg during pregnancy, history of diabetes mellitus, history of macrosomia, prolonged gestational age, and multiparity (parity>=5). There was no significant relationship between mother's job and macrosomia.Conclusion: The prevalence of macrosomia in Khorramabad was high (11.8%). Preventing pregnancy in mothers over 35 years of age by contraception ways, preventing maternal obesity before pregnancy, and control of blood glucose during pregnancy by suitable diet and insulin therapy are recommended to prevent macrosomia.Key words: Macrosomia,neonate,Maternal risk factor,Weighthttp://ijn.mums.ac.ir/article_4141.htmlhttp://ijn.mums.ac.ir/article_4141_2eea5da05c11dfc90bbc15858a127f50.pdfMashhad University of Medical SciencesIranian Journal of Neonatology IJN2251-75102322-21585320141201The effect of an interventional program based on the Theory of Ethology on infant breastfeeding competence1012ENaghdaskarimiPhD student Reproductive health, Students Research Committee , Department Midwifery and reproductive health, Nursing and Midwifery school, Mashhad University of Medical Science, Mashhad, Iran.karimia901@mums.ac.irSepidehBagheriAssistant professor of pediatrics, School of medicine, Mashhad University of medical sciences, Mashhad, Iranmd314@yahoo.comTalatKhadivzadeh: Faculty Member, Nursing and Midwifery School, Women Health Research Center, Mashhad University of Medical Science, Mashhad, Iran.mscmidwife@yahoo.comKhadijehMirzaii NajmabadiAssociate Professor Nursing and Midwifery School, Mashhad University of Medical Sciences, Mashhad, Iranmidwife@yahoo.com10.22038/ijn.2014.4142Introduction: according to the ethology theory mother infant separation immediately after birth can interfere with the infants innate behaviors for the initiation of breastfeeding. The aim of this study was to the effect of an interventional program based on the Theory of Ethology on infant breast feeding competence Materials and Methods: 114 primiparous, Iranian, healthy, full term mothers between 18-35 years with normal vaginal delivery who intended to breastfeed their babies. They were put in direct skin to skin contact with their infants immediately after birth for two hours. Then, rates of infant breastfeeding competence were compared with a control group receiving routine hospital cares. Results: Rates of infant breastfeeding competence were higher in the skin to skin contact group compared to routine care group (p=0.0001). Conclusion: mother- infant early skin to skin contact promotes infants natural feeding behaviors leading to higher rates of infant breastfeeding competence. These findings confirm the Theory of Ethology.Key words: Infant,breastfeeding competence,Theory of Ethologyhttp://ijn.mums.ac.ir/article_4142.htmlhttp://ijn.mums.ac.ir/article_4142_489607d2da54a941983bf8fbb686103a.pdfMashhad University of Medical SciencesIranian Journal of Neonatology IJN2251-75102322-21585320141201Clinical manifestation and laboratory findings in positive blood culture in neonatal septicemia1317ENGholamrezaKhademiMASHHAD UNIVERSITY OF MEDICAL SCIENCESkhademigh@mums.ac.irAhmadShah FarhatDepartment of Pediatrics, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iranfarhata@mums.ac.irAshrafMohammadzadehDepartment of Pediatrics, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iranmohammadzadeha@mums.ac.irMahbobehNaderi NasabDepartment of Microbiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Irannaderi nasabm@mums.ac.irFaridMirzaieDepartment of Pediatrics, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iranmirzaief@mums.ac.ir10.22038/ijn.2014.4143Background/objective: Neonatal septicemia is one of the major causes of mortality in newborns. The aim of this study is to evaluate the clinical manifestations and laboratory findings in positive blood culture in neonatal septicemia. Methods: In this retrospective study, we allocated 100 records positive blood culture of neonates suffering from septicemia. A questionnaire was completed for each patient consisting the age at admission, gender, weight at birth, admission time, type of delivery, pre- or post-term delivery and the clinical symptoms. Types of organism causing sepsis, and their resistance to antibiotics were evaluated and method for empirical treatment was recommended. Results: Respiratory distress, cyanosis and lethargy were more common in the patients. The antibiogram showed Ampicillin resistance in 86% and Gentamycin resistance in 66% of studied records. Also, 36% cases of positive blood culture with gram-negative and 64% with gram-positive bacteria were observed. The most common bacteria in blood cultures were negative-coagulase Staphylococcus (%35), Staphylococcus Aureus (%24), Klebsiella (%18), respectively. Other bacteria were Enterobacter, Escherichia coli and Enterococcus (%5), Acinetobacter (%3), Pseudomonas aeruginosa and Negative-Gram Bacilli (%2) and Ceratia (%1). The most common effective antibiotics against bacterial growth in Antibiograms were Vancomycin, Cephalosporin, Amikacin, Co-trimoxazole and Gentamycin. Conclusion: Since the most common bacteria in neonatal septicemia cases were negative-coagulase Staphylococcus, Staphylococcus Aureus, Klebsiella, the pediatricians must select the regiments that cover gram-negative bacteria for empirical antibiotic treatments.Neonatal septicemia,Laboratory findings,Blood culturehttp://ijn.mums.ac.ir/article_4143.htmlhttp://ijn.mums.ac.ir/article_4143_811c5c51da46f396c83a12a42213c907.pdfMashhad University of Medical SciencesIranian Journal of Neonatology IJN2251-75102322-21585320141201The effects of training based on BASNEF model and acupressure at GB21 point on the infants’ physical growth indicators1824ENmarziehakbarzadehshiraz university medical collegeakbarzadm@sums.ac.irnasrinbahmaniShiraz University of Medical Sciences, Marvdasht, Iranbahmaninasrin@yahoo.commarziehmoattariShiraz University of Medical Sciences, Shiraz, Iranmoattari@yahoo.comSaeedePourAhmadShiraz University of medical sciences , , Shiraz, Iranpourahmad@yahoo.com10.22038/ijn.2014.4144objective: Educational models are used to study the behavior and plan for changing and determining the factors that affect the individuals’ decision making for conducting a behavior. This study aimed to compare the effects of the educational program based on BASNEF model and acupressure at GB21 point on the infants’ physical growth indicators.Methods: This clinical trial was conducted on 150 (50 per group) pregnant women in 2011-2012. The interventions included educational program based on the BASNEF model and application of acupressure at GB21 point. The infants’ physical indicators were compared to the control group one and three months after birth. The study data were analyzed using repeated measurement test, paired sample T-Test, one-way ANOVA, and Tukey’s test.finding: The results showed a significant difference between the intervention and the control group regarding the infants’ weight and height one and three months after birth (p0.05). Also, no significant difference was observed among the three groups concerning the infants’ head and arm circumference (P>0.05).Conclusion: BASNEF model improved the infants’ height and weight. Application of acupressure also improved the infants’ height, weight, and head and arm circumference compared to the control group. Hence, learning and application of techniques and models by the medical team are highly essential.Keywords: GB21 acupoint,BASNEF Model,Acupressure,Physical growth indicatorhttp://ijn.mums.ac.ir/article_4144.htmlhttp://ijn.mums.ac.ir/article_4144_fde7b78e18621a507c43e350cda0fc74.pdfMashhad University of Medical SciencesIranian Journal of Neonatology IJN2251-75102322-21585320141201The pattern of antibiotic administration for toddlers and infants with acute respiratory infections (Mashhad- Iran)2529ENmohammad saeedsasanMashhad University of Medical Sciences, Department of pediatric.sasanms@mums.ac.irvedavakiliDEpartment of community medicine, Mashhad University of Medical Sciencesvakiliv@mums.ac.irshahinSaeedi nejatMashhad University of Medical Sciences, school of hygienesaeedish@mums.ac.irMohammadKhajedaluee2Mashhad University of Medical Sciences, Department of Community Medicinekhajedalueem@mums.ac.ir10.22038/ijn.2014.4145ABSTRACT Background: Acute respiratory infections (ARI) are the main cause for antibiotic (AB) use in all age groups specially the first two years of life. The local information about the pattern of AB prescription in ARI is a necessary part for any program which aims logical use of AB. The current study was designed to find the frequency and types of AB administration for ARI in young children (Antibiotic,respiratory infections,Infants,ARIhttp://ijn.mums.ac.ir/article_4145.htmlhttp://ijn.mums.ac.ir/article_4145_da79aa16fa4c0e9331781a0f76937bda.pdfMashhad University of Medical SciencesIranian Journal of Neonatology IJN2251-75102322-21585320141201Necrotizing Enterocolitis: A dreadful condition of premature babies3031ENDeepakKumarsharmaFernandez Hospital ,ooposite OLD MLA quartersdr.deepak.rohtak@gmail.com10.22038/ijn.2014.4146NEC is inflammatory necrosis of intestine with most common site being terminal ileum and ascending colon in preterm babies (1). The condition is typically seen in premature infants, and the timing of its onset is generally inversely proportional to the gestational age of the baby at birth, i.e. The earlier a baby is born, longer is the time of risk for NEC in premature babies. The incidence of NEC is inversely proportional to the gestational age and birth weight (2). Baby have initial symptoms which include feeding intolerance, increased gastric residuals, abdominal distension and bloody stools (3). The laboratory triad includes metabolic acidosis, hyponatremia and thrombocytopenia. Pneumatosis intestinalis is the pathognomonic radiological finding in the NEC. Modified Bell’s staging is used to stage the NEC. Treatment involves Nil per Oral, supportive care, antibiotics, surgery in advanced stages and parenteral nutrition (4,5). Complication of NEC includes mortality, prolonged NICU stay, intestinal strictures, enterocutaneous fistula, intra-abdominal abscess, cholestasis, and short-bowel syndrome (6,7), neurodevelopmental, motor, sensory, and cognitive problems (8,9).Necrotizing Enterocolitis,premature babies,Modified Bell’s staginghttp://ijn.mums.ac.ir/article_4146.htmlhttp://ijn.mums.ac.ir/article_4146_5670628faa59ebdfb323a31476297cde.pdfMashhad University of Medical SciencesIranian Journal of Neonatology IJN2251-75102322-21585320141201The neonate was born with holoprosencephaly3235ENrezasaeidiassociate Professor of neonatology, Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.saeedir@mums.ac.irabdolhoseinabasifellow ship of neonatology, Neonatal Research Center, Imam Reza Hospital, Mashhad, Iran.abasi.med@gmail.com10.22038/ijn.2014.4147holoprosencephaly is a rare congenital brain malformation resulting from failure of diverticulation and cleavage of primitive prosencephalon which occurs at 4 - 8th week of gestation and is usually associated with multiple midline facial anomalies. it is the most common forebrain developmental anomaly in humans with prevalence of 1/16,000 in live borns, an incidence as high as 1:250 in conceptuses, and a worldwide distribution6. The etiology of HPE is very heterogeneous. First, this pathology can be caused by environmental or metabolic factors. The only formally recognized environmental factors are insulin-dependent diabetes mellitus (1% risk of HPE) and maternal alcoholism with a risk that cumulates with smoking . Clinical expression is variable, extending in unbroken sequence from a small brain with a single cerebral ventricle and cyclopia to clinically unaffected carriers in familial holoprosencephaly. Here. we report a boy 39 weeks neonatal case of holoprosencephaly with Antenatal ultrasonographic diagnosis, with microcephaly, hypotelorism, flat nose, a single nostril, a midline cleft lip and palate microcephaly.holoprosencephaly,midline facial anomalies,ultrasonographic diagnosishttp://ijn.mums.ac.ir/article_4147.htmlhttp://ijn.mums.ac.ir/article_4147_c88031538670cfd6fa62e261fe2340c9.pdf